Plastic and cosmetic surgeryKolle, Frederick Strange
Science
Plastic and cosmetic surgery
Kolle, Frederick Strange
Surgery, Plastic
=Furrow about Canthus= _(Unilateral and Bilateral)_.—This condition is
commonly called “Crow’s Feet,” and is, in the majority of cases, due to
advancing age, but is acquired by habitually contracting the eyelids,
as in laughing or grimacing. It is particularly noticeable in persons
employed in the drama.
The defect is usually bilateral, but may exist at one side only in rare
cases.
The correction is easily accomplished by this method of subcutaneous
injection, although a reduction of the furrow alone does not suffice,
leaving a lump or elevation at the site. The author shades off the
injection, as it were, making the site somewhat conelike, the apex being
at the canthus and the base outward toward the hair line of the temporal
region.
Sterile oil should be injected near the canthus, where the overlying
integument is delicate. One such injection, covering an area of the
diameter of half to three fourths of an inch, should be made, and thus
backed up or built outward with two or three injections of the white
vaselin, as described under temporal muscular deficiency.
The hypodermic needle should be used near the canthus, and the regular
one over or about the temple.
The reaction near the canthus is similar to that with lid injections. The
same post-operative treatment as with the lids should be employed.
=Deficiency of the Ocular Stump.=—It frequently happens that by reason
of extensive inflammatory disease and adjacent adhesions of the eye, a
greater part of the globe must be excised than in the usual case, whether
the operation be an ordinary excision, the Mules’s evisceration or the
Frost modification of the latter.
In such event the granular button or the stump made of Tenon’s capsule
is too small to permit of the placing and retention of the artificial
eye. In other instances the stump is so contracted that while the
artificial eye is retained it must of necessity be allowed to rest deep
in the socket, destroying the entire contour of the orbit. Again in the
enucleation operation so little of Tenon’s capsule engages the artificial
eye that movement is entirely destroyed, particularly when the Mules’s
glass globe has not been introduced.
Excellent results may be obtained in some of these cases, others are not
amenable to the injection method because of a lack of sufficient stump
to inject, and the danger of injecting through the posterior wall of the
capsule, the mass in part escaping into the orbital apex, where it is
liable to impinge sufficiently upon the remains of the optic nerve to
cause sympathetic inflammation of the normal eye. A condition at once not
easily corrected, proving dangerous to the sight of the healthy eye, and
possibly producing a fatal termination.
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